Spot diagnosis: Acromegaly
Acromegaly is a gift in endocrine substation. You should not miss the striking features of acromegaly.
**Face-prominent supraorbital ridges,large nose and tongue, increased interdental separation, prognatism.
Then, proceed to look for:
1) Neck for goiter
2) Visual field for bitemporal hemianopia
3) Hand- carpal tunnel syndrome, spade-like hand, thick , doughy hand with thick hand and sweaty palms
4) Skin- look for skin tag over the axilla.
5) Leg- leg odema ( may indicate heart failure)
Lastly, tell examiners that, you would
1) check abdomen for hepato-splenomegaly and look for testicular atrophy
2) Check BP and urine for sugar
3) Check joint for athropathy
4) Ask for patient's old photo or IC for comparison with current facies features
Tips: As a MRCPian, you are expected to assess the disease activity. Please pay attention to check for sweaty palm, skin tags, visual field and BP.
3) Hand- carpal tunnel syndrome, spade-like hand, thick , doughy hand with thick hand and sweaty palms
4) Skin- look for skin tag over the axilla.
5) Leg- leg odema ( may indicate heart failure)
Lastly, tell examiners that, you would
1) check abdomen for hepato-splenomegaly and look for testicular atrophy
2) Check BP and urine for sugar
3) Check joint for athropathy
4) Ask for patient's old photo or IC for comparison with current facies features
Tips: As a MRCPian, you are expected to assess the disease activity. Please pay attention to check for sweaty palm, skin tags, visual field and BP.
posted by Dr. David Teoh @ 6/23/2006 08:50:00 AM
1 Comments:
Carefrully look and feel the forehead for scars (felt as uneven ridging) from previous transfrontal approach surgery. This is especially true in older patients when transphenoidal surgery was not available yet
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